| NPI | 1043954654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME174794) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 34654) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2025-07-15 |